| NPI | 1760923551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN H BULLARD Clinical Social Worker 803-599-8869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 8752) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-04-28 |